A Travesty

A piece in the Denver Postrecently caught my eye. Titled "A Court for Mental Illness," it was by columnist Susan Thornton and chronicled the establishment of a special court in Colorado's 18th Judicial District designed to serve exclusively people with mental health histories who are charged with a crime, and with the idea of keeping them from behind bars, if possible. Colorado is not the first state to try this method to deal with its burgeoning population of the mentally ill incarcerated in its county jails and state prison system. There are approximately 150 of these courts nationwide.

Currently a quarter million people suffering from one of the three major mental illnesses (schizophrenia, bipolar or manic depressive disorder, and clinical depression) are in U.S. prisons and county jails, costing taxpayers approximately $30,000 per inmate annually. Nationwide, 30% of correctional inmates need mental health services. The average county jail sentence today is 20 days, but psychiatric red tape means the mentally ill average four months, saddling the taxpayer with that extra burden. The mentally ill have a recidivism rate -- for mostly petty crimes -- of 50%. And needless to say, they are subject to the vicious attentions of their fellow inmates in hideous ways.

For four years (1986-90) I served on the ward staff at Vermont State Hospital (VSH) in Waterbury. At the time they were in the process of shrinking their "client" population. In those four years I saw that population cut in half, from roughly 200 to 100, and one building with four wards closed and renovated for office space for the use of other state agencies moving ten miles from the capital Montpelier. In 1965 VSH housed over 1,200 patients. During my tenure I thought the closing-down program was odd, given that Vermont was a low population state (approx. 500,000) with only one state hospital. But this ongoing process was national in scope. It was called "deinstitutionalization" (the sort of word only a politically correct liberal could love).

The deinstitutionalization or "anti-psychiatry" movement started in the 1960s (no surprise there) and is rooted in the psychoanalytic writings of R.D. Laing, a Scottish psychiatrist and author of The Divided Self(1960), a book that seems to have come to many wrong conclusions about schizophrenia, such as emphasizing environmental factors over biological ones; and Thomas Szasz, another psychiatrist , whose book The Myth of Mental Illness(1961), simply dismisses its existence at all. Taken together (if possible), their theories posit that mental illness isn't a pejorative state, but just another way of perceiving reality. Crazy people aren't crazy. And they certainly have a right to pursue their alternate cognitive lifestyles. Toss lawyers into this mix and you have a recipe for blatant social engineering. For years, attorneys representing advocacy groups have successfully sued state hospital systems, the results of these suits actually governing how they operate.

Most of the suits concerned the "rights" of patients to refuse treatment and medication, or arranged a discharge for or against the wishes of the family. It became a case of the inmates -- actually their lawyers -- running the asylum. Over the years as hospitals closed or shrunk, most states set up county-based group homes that are light on security, and not popular if you happen to live in the same neighborhood. Or patients are simply discharged from hospitals as "stabilized," when they're not considered a threat to themselves or others, but sometimes with tragic results.

Take America's "homeless" problem, for example. Liberals believe it is axiomatic that people living on the streets are economically oppressed. But anyone who has ever encountered a disheveled and delusional panhandler on a city street knows better.

To borrow a phrase popular on the Left, deinstitutionalization is the "root cause" of the homeless problem. Other than during the Great Depression, America has never seen a time like the last three decades, where large numbers of people were living out-of-doors in parks, under freeway overpasses, or on city streets. While liberals are notorious for padding such numbers, it's likely that 125,000 (2007) "chronically homeless" people currently live this way. And it's estimated that 57% have mental health histories. Compounding this are high rates of alcoholism and drug abuse (27%) among these poor souls. And this, in turn, means that these folks many times attract the attention of law enforcement.

The prison system won't stand this strain for long. Soon there will be calls from the Left to provide separate facilities for the incarcerated mentally ill. They will need a safe environment free of the depredations of the criminal-types. Places where their particular diagnosis can be carefully treated through medication and a host of therapeutic programs designed to heal them and once more integrate them with society. And these facilities can have minimum security sections designed for patients with minor or no criminal records at all. Maybe they can be operated by the private sector, such as many "correctional facilities" are today.

In short, the anti-psychiatric Left will insist on reopening many of those shuttered mental hospitals. Or they'll clamor for the construction of new ones (that's a plea more likely as liberals when given a choice will always choose to spend other people's money on grandiose self-serving projects). After all, they have only the best interests of the mentally ill in mind. Right?

This is a terrible state of affairs, but don't expect people who destroyed a humane and efficient national mental health system that was constantly improving its pharmacological expertise to apologize for it. According to a State of Vermont websitededicated to mental health issues, in 2009 VSH still maintained 54 beds for the Green Mountain State's severely mentally ill. Much of the patient diaspora has dispersed to the county group homes over the years. But how many of them are in jail? And how many sleep on the streets or in the homeless shelters of Burlington, Rutland, and Montpelier? How many?

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